Rhitodoplasty - Face Lift

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Disclaimer: The details in this section are for general information only. Always check with your own doctor.

Why have a facelift?

Facelifting is designed to reduce the sagging, excess skin in the mid and lower face and it helps to improve the tone of the underlying structures.

The Procedure

Local anaesthetic is inserted with adrenaline to minimise bleeding and to help the surgeon define where to make the incision.
A continuous incision is made running from the temple downwards, hugging the contours at the front of the ear, rounding the earlobe to travel up behind the ear in its natural crease, then along the hairline. In men, the incision in front of the ear hugs the back of the sideburn in order to prevent pulling the sideburn hair on to the front of the ear when the skin is redraped.
The skin is now carefully lifted off the underlying muscle up to an imaginary line that drawn down from the corner of the eye. The flap will not be made any bigger than this as there would be a chance that the blood supply could not support the raised skin.
After the skin is raised, the underlying tissue is gently pulled up and stitched into place in order to give better form to the face and jawline once the skin is laid back down. This is carried out in both the face and upper neck. Additional liposuction under the chin may be necessary.
The skin flaps are now laid back down with the excess skin being trimmed off to reduce any previous laxity. The surgeon will be careful not to remove too much skin as this would give a tight, “windswept” look. It is also vital that there is no tension around the earlobe as this may result in it being pulled down to give a “pixie-like” appearance.
The skin is then held in place by both absorbable stitches under the skin and non-absorbable stitches at the skin edges. A small vacuum drain is inserted behind the ear in order to remove any blood underneath the flaps and to suck the flaps down on to the underlying tissue.

After the operation

Antibiotic cream is now placed over all of the incisions followed by gauze dressings and a gauze bandage. The following day, the bandages are removed to check the wounds and the drains are removed.
A lighter dressing is then applied, to be removed the next day at home. The stitches are then removed a week after surgery. Male patients can begin shaving after one week and are advised to use an electric razor which is generally less abrasive. The patient will have further follow-up appointments 1 month, 6 months and a year after the surgery.

Possible Complications

Complications are rare but the most common one is bleeding and blood clots. This is usually avoided by meticulous control of bleeding at the time of surgery along with insertion of a drain and supportive facial bandaging.

In addition to these measures, it is important to stop medications that prevent coagulation two weeks before the operation, until two weeks afterwards. Examples of these medications are aspirin, warfarin and anti-inflammatory medications.
Infection and necrosis (death of tissue) are rare as antibiotics are applied post-operatively and wounds are monitored to ensure that the first signs of a problem are picked up quickly. To reduce the potential for this occurring even further, patients who smoke should cease at least four weeks before the operation until at least two weeks afterwards, so that the small blood vessels in the face work to their maximum potential.
Nerve damage should almost never occur where a careful procedure has been performed.
Scars will always be present after surgery but these are usually hidden in natural facial lines and creases. Occasionally they can widen or become hypertrophic (swollen), this being a particular problem in Asian, Latin or African skin types. If severe it can be treated with steroid creams or injections and occasionally, if very obvious, revision of the scar surgically is also an option.